Individual provider Active NPI

Thomas Cannone

  • Optician
  • Ridgewood, NY
National Provider Identifier
1013671593
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
009495 Issued in NY
Practice address
6115 Metropolitan Ave
Ridgewood, NY 11385-2644
Phone
(718) 312-6959
Fax
(718) 497-1055
NPI assigned
Oct 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 009495 NY Primary

Addresses

Primary practice location

6115 Metropolitan Ave
Ridgewood, NY 11385-2644

Mailing address

1 CVS Drive
Mail Stop #3005
Woonsocket, RI 02895
Phone (401) 770-2286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
009495NYMDSkilled Nursing Facility

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Aoc Corporation Optician CurrentSince Oct 31, 2021 Accepting new patients

Locations

1 Cvs Dr
Stop 3005
Woonsocket, RI 02895

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1013671593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DRIVE",
            "address_2": "MAIL STOP #3005",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "02895",
            "telephone_number": "401-770-2286",
            "fax_number": "401-269-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 METROPOLITAN AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113852644",
            "telephone_number": "718-312-6959",
            "fax_number": "718-497-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNONE",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "009495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.